Post-traumatic stress disorder (PTSD) induced by life-threatening medical events has
been associated with adverse physical and mental health outcomes, but it is unclear
whether early interventions to prevent the onset of PTSD after these events are efficacious.
We conducted a systematic review to address this need. We searched six biomedical
electronic databases from database inception to October 2018. Eligible studies used
randomized designs, evaluated interventions initiated within 3 months of potentially
traumatic medical events, included adult participants, and did not have high risk
of bias. The 21 included studies ( N = 4,486) assessed a heterogeneous set of interventions
after critical illness (9), cancer diagnosis (8), heart disease (2), and cardiopulmonary
surgery (2). Fourteen psychological, 2 pharmacological, and 5 other-type interventions
were assessed. Four of the psychological interventions emphasizing cognitive behavioral
therapy or meaning-making, 1 other-type palliative care intervention, and 1 pharmacological-only
intervention (hydrocortisone administration) were efficacious at reducing PTSD symptoms
relative to control. One early, in-hospital counseling intervention was less efficacious
at lowering PTSD symptoms than an active control. Clinical and methodological heterogeneity
prevented quantitative pooling of data. While several promising interventions were
identified, strong evidence of efficacy for any specific early PTSD intervention after
medical events is currently lacking.